N520 Topics 13 - 16 Topic 13 - Gastrointestinal/Abdominal assessment Questions that may come up in group ● Main thing to remember when assessing the abdomen - ORDER ○ 1)Inspect 2)Auscultate 3)Percuss 4)Palpate Why is this? So not to stimulate the GI tract and get false data ● Know the terms used to describe bowel sounds present and absent. ● Different percussion sounds heard during GI assessment ● Different auscultating sounds How long to listen for an accurate analysis - 5 mins ● Aortic aneurysm - pulsating mass middle of abdomen ● Dysphagia - speech therapist diagnoses by conducting swallow studies ● Inserting NG tube - Procedure for NG insertion - know the steps, how do you determine the length of the NG tube and if the placement is correct? ○ Measure in cm starting at the ■ tip of the nose, to ear lobe, and then to the xiphoid process ● Know the organs in each quadrant including the epigastric area - There were more questions about this then many students were prepared for. ○ RUQ liver, gallbladder, duodenum, head of the pancreas, right kidney/adrenal, ascending colon, transverse colon ○ RLQ cecum, appendix, right ovary/tubes, right ureter, right spermatic cord, ○ LUQ stomach, spleen, body of pancreas, left kidney/adrenals, descending colon ○ LLQ left ovary/tubes, left ureter, left spermatic cord, part of descending colon, sigmoid colon ○ Epigastric lungs/heart? Check book ● Diaphragm for bowel sounds and bell for vascular sounds - define hypoactive sounds and absent sounds ● Spleen - How to palpate for the spleen? If you are able to palpate? Stop Next steps? Contact provider ● Liver - How to palpate for the liver? mean sizes for male(10.5 cm) and female(7cm)(cm) Abnormal findings ● Slide 38 has links to youtube videos showing Blumberg sign, iliopsoas test, Murphy’s sign. ○ Appendicitis-Iliopsoas test https://www.youtube.com/watch?v=n0a0PCwsVQ4 ○ Abdominal pain-Rebound tenderness-(Blumberg Sign) https://www.youtube.com/watch?v=2mfiGIDJfnM N520 Topics 13 - 16 ○ Gallbladder inflammation-Inspiratory Arrest (Murphy Sign) https://www.youtube.com/watch?v=9L7N89sOSuc sometimes can be mistaken for angina ○ What is happening to give these signs and symptoms? ● Kidneys are located by percussing where on the body? ○ Posterior at the 12th ribs and vertebral column creating the costovertebral angle. ● Difference between deep and light palpation? ● Organomegaly ● What are the cardinal rules of safety? ○ Never leave alone ○ Follow speech pathologist - thickened food, helpful positioning client may have unilateral weakness and the notes will let you know what side of mouth the food should go on. ○ 90 degree angle ○ Slightly flex head keeping it midline - this prevents? ○ Watch the size of the bites given, food, even if it is pureed, thickened. Give the proper amount of time to chew. Food should be broken down quite a bit in the mouth, chewing up to 30 times for a single bite. On the other hand if a client has neurological weakness in mouth, bad teeth, chronic dry mouth (which is a common side effect of medications). ○ Have the client stay in an upright position for at least 15 to 30 mins after eating. ○ If client is holding food in mouth for longer than 10 seconds this is a sign of DANGER Topic 14 Defining Social Interaction Assessment - Building Relationships Framework This was in N520P if there was any reading associated with this topic, make sure to go over it and remember all topics can be on the exams. Topic 15 Genitourinary System Notes in red are mentioned on Katie’s study guide 3 Questions that may come up in group ● Terms to know/understand in context ○ Hesitant ○ Dysuria ○ Stress incognito ○ Nocturia ○ Hematuria ○ Oliguria N520 Topics 13 - 16 ○ Anuria ○ urgency ● What are the normal ranges for a urinalysis? ○ Specific Gravity 1.050-1.030 specific gravity will be elevated with a UTI - urine will be more concentrated ○ pH - 4.5 - 8 pH (6pH) UTIs will present with a pH >8 ○ Normal BUN 10-20 mg/dL ○ Creatinine normal levels 0/6-1.2mg/dL - 8.0 ○ WBC High during infection ● Cremaster muscle - what does it control? ○ Muscle making up the scrotum, contracting as a response to cold. Contracts to pull testes closer to the body in reaction to cold ● Prostate - glandular structure … ● Scrotum - external male genitalia structure ● Acute pain length chronic pain length ● FLuid volume overload/deficit Topic 16 - Mental Health This was N520P - There were quite a few mental health, substance abuse(future topic) questions on the final exam, remember to pay attention to this material. ● Make sure to go through this powerpoint, focusing on determining a client needs a mental assessment. ABCT N225P Topic 16 mental status assessment power point.pptx ● What behaviors prompt a provider to conduct a mental health assessment? Mood and affect not reflecting each other. Smiling and crying, showing no emotion yet their Mom just died in front of them.
